[Microalbuminuria or pauci-albuminuria?].
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Biomedical subjects
Publications and source records attributed to F Trivin.
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Thirteen biochemical parameters and five enzymatic activities were determined on sera of 63 normal human fetuses sampled by direct puncture under ultrasound guidance, between the 20th and the 26th wk of gestation, and on their mothers. They were referred to us for various prenatal diagnoses but were well and confirmed healthy at birth. Some parameters were found to be very similar in both groups, mainly creatinine, calcium, creatine kinase, aspartate aminotransferase, and gamma-glutamyl transferase. Some values were significantly higher in the fetuses, such as total bilirubin, direct bilirubin, phosphorus, lactic dehydrogenase and alkaline phosphatase activities, and alpha-fetoprotein. Urea, uric acid, glucose, triglycerides, cholesterol, total protein, and albumin levels were found to be lower in fetuses. These data indicate a slower metabolism in fetuses compared to their mothers, a lower level of energy requirement, and a relative liver immaturity. These normal values of fetal biochemistry will improve our knowledge of physiology and help to determine the specific values of a test in fetal pathology.
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Use of cholestyramine made it possible to shorten the daily duration of phototherapy in a case of congenital nonobstructive, nonhaemolytic jaundice. Treatment at home was therefore possible, allowing normal parental care. Development and neurological examinations were normal at the age of 27 months. Frequent determinations of reserve bilirubin binding capacity may be useful in controlling such management.
Knowledge of the reserve bilirubin-binding capacity is useful in management of hyperbilirubinemia in the newborn. We describe thin-layer gel chromatography that permits measurement of this variable, with a 250-mul sample of serum, within 50 min. Single samples from four different infants can be analyzed on the same plate. The capacity of 40 sera from jaundiced and of 19 sera from nonjaundiced infants was measured. Results by thin-layer Sephadex gel chromatography and column Sephadex chromatography correlated well. Dithiothreitol, added to the standard bilirubin solution, protected bilirubin from oxidation for at least six days, which obviated the time consuming preparation of standard solution before such determination.
The main stages of bilirubin metabolism and the present state of neonatal hyperbilirubinemia are reviewed. The heterogeneity of substrates for bilirubin synthesis and the regulation of the heme-oxygenase activity are stressed. The importance of albumin for the bilirubin transport and the factors modifying this transport are studied. The detection of free bilirubin and reserve bilirubin binding capacity in neonatal jaundice is discussed as a method to estimate the risk of kernicterus. The induction of bilirubin glucuronyl transferase activity with some drugs and the phototherapy are effective in the treatment of hyperbilirubinemia; their values are discussed from the most recent reports.
Because of the great difficulty of BSP dialysis in automatized determinations in serum the authors investigated the effect of sodium salicylate. They proved its good performance with aqueous and proteic solutions of BSP. About 70 mul of patient sera is used to perform the analysis with Technicon Autoanalyser. Comparison of data from about 220 serum evaluated by their proposed method and manual technique are studied.
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The in vivo procedure for retrovirus-mediated gene transfer into rat liver allows genetic modification of 1 to 5% hepatocytes and the expression of a foreign gene for more than one year. We have used the Gunn rat as a model of the human Crigler-Najjar type I syndrome to assess the pertinence of this approach for the treatment of severe liver genetic diseases. After transfer of the rat bilirubin uridin diphosphate-glucuronosyl transferase cDNA into hepatocytes, 15 Gunn rats were examined during several months and sacrificed. Bilirubin glucuronides were excreted in the bile of all recipients, and serum bilirubin levels were significantly reduced in the treated population. The decrease was more than 40% in 5 of the 15 rats. These date showed that long term expression of a therapeutic protein can be obtain after in vivo retrovirus-mediated gene transfer into the liver.
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